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Health Care Spending Targeted By American College Of Physicians Guidelines

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A breast cancer patient is helped by a technician after a CT scan at the UCSF Comprehensive Cancer Center
A breast cancer patient is helped by a technician after a CT scan at the UCSF Comprehensive Cancer Center

A proposition from a major physicians group is catching flak for evoking the specter of "rationing" medical care for those in need. But the group says its proposal could save hundreds of billions of dollars and improve patients' health.

The American College of Physicians this year introduced new guidelines that could reign in the costs of medical tests. The idea is to help doctors better target individual patients' needs--instead of over-prescribing tests that could possibly even harm patients. The shift could save a lot of money, time, and hassle.

Steven Weinberger, the organization's chief executive officer, told Reuters that unnecessary medical tests waste as much as $250 billion every year. "There's an overuse of imaging studies, CT scans for lung disease, overuse of routine electrocardiograms and other cardiac tests such as stress testing," Weinberger told Reuters. A 2009 Thomson Reuters analysis estimated total waste in the U.S. health care system to be as high as $850 billion a year.

The physicians' society, which has about 132,000 members, aims to tackle one of the stickiest problems in the U.S. health care system: how to trim costs without reducing the quality of medical care. The American College of Physicians also is endorsing the argument that over-testing of patients not only creates unnecessary spending, it also subjects people to risks and anxiety and may lead to treatments they could have gone without.

The medical society published its new ethics guidelines last month in the Annals of Internal Medicine and identified 37 types of cases when physicians should think twice before ordering tests that may be wasteful and possibly harmful to the patients, Reuters reported.

The American College of Physicians' new guidelines have generated controversy that reflects the ongoing debate about how much the U.S. should spend on health care and how we should allocate those resources. In particular, critics have seized on the use of the word "parsimonious" in the document.

Physicians have a responsibility to practice effective and efficient health care and to use health care resources responsibly. Parsimonious care that utilizes the most efficient means to effectively diagnose a condition and treat a patient respects the need to use resources wisely and to help ensure that resources are equitably available.

This is worrisome to those who fear medical care will be denied to people in need because of cost or because they are too old or too sick. "The word itself carries a connotation that is going to give people pause if it’s a precursor to rationing," Rep. Michael Burgess (R-Texas), a physician who opposed Obama's health law along with all other congressional Republicans, told Kaiser Health News.

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